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共济失调毛细血管扩张症:尼泊尔的一例罕见病例报告。

Ataxia telangiectasia: a rare case report from Nepal.

作者信息

Upreti Apil, Mandal Prince, Upreti Amit, Sapkota Srijana, Acharya Sristi, Yogi Avash, Gauchan Bikash, Bhattarai Suman, Thapa Lekhjung

机构信息

Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Maharajgunj.

Special School for Disabled and Rehabilitation Center.

出版信息

Ann Med Surg (Lond). 2024 Feb 15;86(4):2149-2153. doi: 10.1097/MS9.0000000000001831. eCollection 2024 Apr.

Abstract

INTRODUCTION AND IMPORTANCE

Ataxia telangiectasia (A-T) is a rare autosomal recessive neurodegenerative disorder with early childhood onset. It is characterized by ataxia, oculocutaneous telangiectasia, immunodeficiency, and lymphoid-origin cancer predisposition due to ataxia telangiectasia mutated gene mutations.

CASE PRESENTATION

The authors present a 19-year-old girl with spastic movements since 18 months, leading to wheelchair dependence. Ocular telangiectasia, dystonic posture, and slurred speech were evident. Diagnosis involved elevated alpha-fetoprotein levels and typical brain imaging.

CLINICAL DISCUSSION

A-T due to ataxia telangiectasia mutated gene mutations located on chromosome 11q22-23. It has varied presentations categorized by age and features. Timely diagnosis relies on characteristic symptoms, lab findings, and imaging. Radiation sensitivity and increased cancer risk underscore cautious radiation use.

CONCLUSION

A-T is a complex disorder with no cure. Genetic counseling for parents is vital. Its poor prognosis due to infection susceptibility and cancer risk necessitates supportive care. Comprehensive management, including genetic counseling and careful surveillance, is imperative.

摘要

引言与重要性

共济失调毛细血管扩张症(A-T)是一种罕见的常染色体隐性神经退行性疾病,于儿童早期发病。其特征为共济失调、眼皮肤毛细血管扩张、免疫缺陷,以及因共济失调毛细血管扩张症突变基因突变导致的淋巴源性癌症易感性。

病例介绍

作者报告了一名19岁女孩,自18个月大起出现痉挛性运动,导致依赖轮椅。眼部毛细血管扩张、张力障碍姿势和言语不清明显。诊断包括甲胎蛋白水平升高和典型的脑部影像学表现。

临床讨论

A-T由位于11q22-23染色体上的共济失调毛细血管扩张症突变基因突变引起。它有多种表现形式,按年龄和特征分类。及时诊断依赖于特征性症状、实验室检查结果和影像学检查。辐射敏感性和癌症风险增加强调了谨慎使用辐射。

结论

A-T是一种无法治愈的复杂疾病。为父母提供遗传咨询至关重要。由于易感染和癌症风险,其预后较差,需要支持性护理。包括遗传咨询和仔细监测在内的综合管理势在必行。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f63/10990361/06722c5604a6/ms9-86-2149-g001.jpg

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